Splenectomy in children. A correlative review of indications and complications in fifty patients

We have reported our experience with splenectomy in fifty patients less than fourteen years old. The indications, results, and complications were enumerated. These data were then correlated with the recent literature regarding pediatric splenctomy. Of special note is the problem of immunologic incompetency associated with splenectomy in the patients less than five years old.     

High-peak-power room-temperature GaAs laser arrays

The current procedures that are employed in the design and fabrication of high-peak-power room-temperature GaAs laser arrays are presented. The methods of material selection and heat-sink preparation are illustrated. Specific mention is made of the laser-chip packing densities that produce effective laser-array brightness in the 100 kW/cm²region. Actual arrays have been constructed that produce 1 kW peak power with 400 amperes peak of modulator current at 1 kHz, or 600 watts peak at 300 amperes peak at 5 kHz. For modulator-current pulses less than 35 ns, these arrays can be expected to operate for 10¹⁰pulses. For field-lens apertures only a few inches in diameter, beam divergences from these arrays of only a few milliradians can be realized. Data relating the power output as a function of pulsewidth, repetition rate, and modulator current for several array configurations are presented. Differential quantum efficiency and overall power-efficiency data and curves are illustrated for typical diode and array configurations. The schemes employed to select and interface various optical components necessary to produce the desired beam divergences from reasonably sized apertures are discussed. Brief mention is made of the parameters of the laser-junction radiation densities necessary to maximize the array operating lifetime.     

Histamine H1- and H2-receptor vasodilation of canine intestinal circulation

Studies were conducted in anesthetized dogs to determine whether the mesenteric vasodilator response to histamine is mediated by H1 receptors alone or whether H2 receptors are also involved in the response. Evidence favoring a role for both receptors included: 1) the vasodilator response to histamine was inhibited by either the H1-receptor antagonist, tripelennamine, or the H2-receptor antagonist, metiamide; 2) both the H1 agonist, 2-methylhistamine, and the H2 agonist, 4-methylhistamine, induced dilator responses in the mesenteric circulation; and 3) two temporal patterns of vasodilation could be distinguished, namely a transient spike and subsequent fade of blood flow (seen with either the H1 agonist or with histamine after H2-receptor blockade) and a sustained and stable increase in flow (seen with either the H2 agonist or with histamine after H1 blockade). Metiamide appeared to be a potent inhibitor of the mesenteric vasodilator response to histamine at least equal to tripelennamine.     

Studies of the reactions of anhydrosulphites of α-hydroxy acids,part IX. thermal polymerisation of anhydrosulphites of α-hydroxy α-methyl carboxylic acids

The anhydrosulphites of a series of unsymmetrically substituted α-hydroxy acids have been prepared and their susceptibility to polymerisation by thermal decomposition studied. The first order rate determining ring scission process, leading to the formation of a reactive α-lactone intermediate which then undergoes spontaneous polymerisation, is the predominant mechanism even with substituents up to C₈. As the length of the n-alkyl substituent is increased the rate of decomposition and thus polymerisation increases until a plateau value is reached at around C₃. Further increase in substituent length decreases the rate of decomposition, an effect which is attributed to steric hindrance of the leaving group by long (C₆—C₈) substituents.     

Tuberculosis of the breast

Twenty-one cases of mammary tuberculosis are reported and the attendant clinical and histological difficulties described. It is probable that contemporary clinicians would now make the clinical diagnosis of breast abscess or carcinoma. Furthermore, the histological features (without demonstration or culture of the organism) may be confused with those granulomatous epithelloid reactions seen in mammary duct ectasia (comedo cell mastitis, plasma cell mastitis) and in traumatic fat necrosis.     

Quantitative blood speed imaging with intravascular ultrasound

Previously, we presented a method of real-time arterial color flow imaging using an intravascular ultrasound (IVUS) imaging system, where real-time RF A-scans were processed with an FIR (finite-impulse response) filter bank to estimate relative blood speed. Although qualitative flow measurements are clinically valuable, realizing the full potential of blood flow imaging requires quantitative flow speed and volume measurements in real time. Unfortunately, the rate of RF echo-to-echo decorrelation is not directly related to scatterer speed in a side-looking IVUS system because the elevational extent of the imaging slice varies with range. Consequently, flow imaging methods using any type of decorrelation processing to estimate blood speed without accounting for spatial variation of the radiation pattern will have estimation errors that prohibit accurate comparison of speed estimates from different depths. The FIR filter bank approach measures the rate of change of the ultrasound signal by estimating the slow-time spectrum of RF echoes. A filter bank of M bandpass filters is applied in parallel to estimate M components of the slow-time DFT (discrete Fourier transform). The relationship between the slow-time spectrum, aperture diffraction pattern, and scatterer speed is derived for a simplified target. Because the ultimate goal of this work is to make quantitative speed measurements, we present a method to map slow time spectral characteristics to a quantitative estimate. Results of the speed estimator are shown for a simulated circumferential catheter array insonifying blood moving uniformly past the array (i.e., plug flow) and blood moving with a parabolic profile (i.e., laminar flow)     

The effect of design on the usability and real world effectiveness of medical devices: A case study with adolescent users

Adolescents are currently overlooked in many fields of healthcare research and as a result are often required to use medical devices that have been designed for use by either children or adults. This can lead to poor adherence and a reduction in health outcomes.